| NPI | 1619207800 |
|---|---|
| Former Name | CYNTHIA M BOUDREAU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211804) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV PT003917) |
| 225100000X Physical Therapist (Licence: MD 26201) | |
| 225100000X Physical Therapist (Licence: PA DAPT002724) | |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2019-01-08 |